Kinesiology Taping: Should You Believe The Hype? (Part I)

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Every drug store carries “kinesiology tape,” for anyone to pick up and buy now. It is common to see athletes, children, and adults with tape on them for various musculoskeletal issues. Some taping designs are simple, some are elaborate, and there are some that look like those paper snowflakes I used to make when I was kid. But does it really matter how you tape someone? Do the claims of the various purveyors of taping have any scientific support? Do you need to take an expensive continuing education course? Is this yet another overhyped treatment that therapists put in their toolbox regardless of efficacy? Putting questionable biological plausibility aside, is there is any reason to think taping does anything besides look cool and make the person feel better? There is only one way to answer these questions, and you should know the answer by now.

We have a few questions to ponder:

What do proponents of kinesiology taping claim it can do?

What does the scientific evidence suggest, in regards to these claims?

Based on the evidence, should we utilize kinesiology taping?

Let’s start with the claims of the two bigger taping companies, in no particular order. Putting multi-colored tape on your body can:

Modulate pain

Up-regulate or down-regulate muscle tone

Improve strength

Decrease swelling and inflammation

Assist with vascular and lymphatic circulation

Provide support and stability to joints and muscles

Re-educate the nervous system

Optimize performance

Decrease muscular fatigue

Improve posture

Prevent injury

Improve ROM

Alarm bells should be going off on your bullshit detector here. The biological plausibility is questionable, the claims are bold, and they are selling you something positioned as an adjunct treatment that can help any patient you ever have. These claims are always couched with the fact that they are supposed to be part of a multi-modal treatment. And don’t worry, there is a course near you! Now while the plausibility of these claims is suspect, it is not completely out of left field. It is not unreasonable to suggest that taping could have some effects that we may be interested in, so let’s get to the evidence. To save time, we will look at the highest quality studies with the least risk of bias; placebo-controlled trials.

Pain Modulation

Let’s start with with the most common claim; applying elastic taping can decrease pain. On this point, they are right! However, it doesn’t reduce pain much more than any sham taping, and the effects are generally small and not long lasting.

In Gonzales Iglesias et.al. 2009, the authors studied the effects of taping versus sham taping (no tension) on patients with C/S pain associated with whiplash. They found that those who had the real taping had statistically significant decreases in pain as well as improvements in ROM, while the sham group did not. However, the effects were small and not clinically meaningful.

“It should be recognized that although the difference between groups were statistically significant, they did not surpass the minimal clinically important difference for pain, which has been reported to be 2 points on a NPRS. Additionally, none of the differences between groups for improvements in cervical range of motion surpassed the minimal detectable change for the respective measurements.”

In Simsek et.al. 2012, the authors studied the effects of taping versus sham taping for patients with subacromial impingement syndrome. The patients with real taping had better outcomes on the VAS and DASH as compared to sham taping. However, it is not clear if blinding was successful.

“Our results showed that KT treatment in addition to exercise therapy may contribute to improvements in pain, function, painless ROM and muscle strength in patients with SIS.”

In Castro-Sanchez et.al. 2012, the authors studied the effects of taping versus sham taping in low back pain and found that the taping group did have statistically significant reductions in pain and disability as compared to the sham group. But again, these effects were small and not clinically meaningful.

“The effect of the taping on pain was also relatively small our best estimate of the effect (ie, an improvement of 1.2 cm on a 10-cm VAS) was below the minimum clinically worthwhile effect of 2 cm (Hagg et al 2003), although the upper limit of the 95% CI did reach this threshold.”

In Parreira et.al. 2014, the authors investigated the effects of taping versus taping with no tension on patients with chronic back pain. You guessed right again…no differences were found between groups.

“After four weeks of treatment, both groups in this trial showed similar reductions in the primary outcomes of pain intensity and disability, with no statistically significant differences between the two treatment conditions.”

In Kocyigit et.al. 2015, the authors investigated the effects of taping versus no tension sham taping (they used average surgical tape), for patients with knee osteoarthritis. Both groups reported decreased pain, but there were no statistical differences between each group.

“The findings of the present study indicate inconclusive evidence of a beneficial effect of KT over sham taping in knee osteoarthritis.”

In Wageck et.al. 2016, the authors investigated the effects of various taping techniques versus sham taping on patients with knee osteoarthritis. Specifically for pain, the authors found no differences between groups.

“In the present study, beside the direct method of measuring pain, two questionnaires that include questions related to pain (Lysholm and WOMAC) were also used, and the score was isolated and analysed from the pain domain from the WOMAC questionnaire. There were still no between-group differences in pain.”

Tone Modulation and Improved Strength

Purveyors of kinesiology taping also suggest that it can be used to up-regulate or down-regulate muscle tone, depending on the way a person is taped, as well as improve strength. This claim barely passes the plausibility test on its face, but it is easily testable. It is also reasonable to conclude that any reductions in pain, via placebo or not, could have some effect on strength.

In Gomez-Soriano et.al. 2013, the authors tested the effects of facilitatory taping versus sham taping on calf muscles of healthy subjects by assessing passive resistive torque, MVIF, tissue extensibility, and muscle EMG activity. To their credit, the authors utilized a double-blind research design. No differences were found between groups.

“Our findings demonstrate that the application of KT on the gastrocnemius muscles has no effect on healthy muscle tone, extensibility nor strength.”

In Anandkumar et.al. 2014, the authors tested the effects of facilitatory taping versus sham taping with no tension on patients with knee osteoarthritis on isokinetic quad torque. The authors found significant differences in favor of the real taping group.

“The results indicate that KT significantly improves the concentric and eccentric quadriceps torque production in knee osteoarthritis at angular velocities of 90 per second and 120 per second respectively.”

In Fernandez de Jesus et.al. 2015, the authors investigated the effects of facilitatory taping versus sham taping on quadriceps strength in healthy subjects and found that there were no differences between groups at any time period.

“The aim of this randomized, blind, clinical trial was to assess the effect of KT on quadriceps strength and lower limb function of healthy individuals over a 7-day period. KT didn’t promote modulations in both parameters analyzed in these individuals at the present investigation.”

In Cai et.al.2016, the authors tested the effects of facilitatory, inhibitory, and no taping conditions on maximum grip strength, EMG activity of the wrist extensors, and self-perceived performance in healthy subjects. And for extra credit, the authors successfully eliminated the placebo effect by blindfolding their patients and only telling them that may need to apply “adhesive muscle sensors” (actually, it was the tape) to test muscle recruitment. The authors found no statistical differences for any outcome measure between the three conditions, suggesting there is no inhibitory or facilitatory effect.

“Our findings were consistent with our original hypotheses that, with the elimination of placebo effect, KT did not facilitate or inhibit muscle activity and change the functional performance in healthy adults.”

Circulatory and Lymphatic Modulation

It has also been suggested that applying kinesiology tape can help to “microscopically” lift the skin, thereby improving circulation and lymphatic flow. Let’s see what the best evidence suggests.

In two studies from Aquilar-Ferrandiz et.al. in 2013 and 2014, the authors assessed the effects of taping for patients with chronic venous insufficiency. In the earlier study, there was no difference in limb volume between traditional taping and sham taping. However, in the second study, there was a significant difference in favor of the traditional taping group, as measured by biolectrical impedance.

“However, KT had no effect on quality of life, leg edema, or ROAM. The placebo group also experienced a posttreatment improvement in pain, though smaller, suggesting that this technique has a placebo effect on pain intensity.”

In Nunes et.al. 2015, the authors investigated the effects of taping designed for reduction of swelling versus inert sham taping on patients with lateral ankle sprains. For all outcome measures, there were no differences between groups after three days.

“Despite applying Kinesio Tape directed by the creators of the tape, the experimental intervention with Kinesio Taping did not show any benefit in terms of a decrease in swelling after an acute ankle sprain when compared to a sham taping technique.”

Embellishment?

Based on high quality placebo-controlled trials, the claims from elastic tape manufacturers seem to be slightly…embellished. For the three most common proposed benefits; decreased pain, tone and strength modulation, and decreased swelling, the best trials are underwhelming. There is either no difference between the recommended taping technique and a sham technique, the effect sizes are not clinically meaningful, or there are conflicting results between similarly-designed studies. It is obvious elastic taping has some effect, but we haven’t seen any evidence to suggest it is big enough to care. In part two, we will take a broader look at the research as a whole with some reviews and meta-analyses.